Metastatic salivary gland carcinoma: A role for stereotactic body radiation therapy? A study of AIRO-Head and Neck working group.

Published on Dec 15, 2020in Oral Diseases2.613
· DOI :10.1111/ODI.13755
Ciro Franzese19
Estimated H-index: 19
(Humanitas University),
Rossana Ingargiola2
Estimated H-index: 2
+ 13 AuthorsEster Orlandi22
Estimated H-index: 22
Sources
Abstract
Objectives The role of radiotherapy (RT) for oligometastases is currently established in different oncological settings but data on salivary gland cancer (SGC) are lacking. We evaluated the role of RT in oligometastatic SGC patients, focusing on stereotactic body radiation therapy (SBRT). Materials and methods We performed a retrospective, multicentric study of oligometastatic SGC treated with palliative RT or SBRT. Endpoints included response evaluation and local control (LC). Results Between 2006 and 2016, 64 patients were collected from 9 Italian Cancer Centers, on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Head and Neck Working Group. 37 patients (57.8%) were suffering from adenoid cystic carcinoma (ACC) and 27 patients (42.2%) had non-ACC. Thirty-four patients underwent palliative RT (53,1%), and 30 received SBRT (46,9%). Most common metastatic sites were bone for palliative RT and lung for SBRT. Among patients treated with SBRT, an objective response or a stability was observed in all treated lesions. After a median follow-up of 29.2 months (range 2.3-117.1), LC at 12 months was 57.5% for patients treated with SBRT and was higher in ACC subgroup. Conclusion We confirmed the potential role of SBRT in the management of oligometastatic SGC patients to control limited burden of disease considering the absence of effective systemic therapies.
References28
Newest
#1Stefano CavalieriH-Index: 8
#2Luigi MarianiH-Index: 50
Last. Laura D. LocatiH-Index: 31
view all 17 authors...
Abstract Background Distant metastases in adenoid cystic carcinoma (ACC) are common. There is no consensus on the management of metastatic disease because no therapeutic approach has demonstrated improvement in overall survival (OS) and because of prolonged life expectancy. The aim of this study is to build and validate a prognostic nomogram for metastatic ACC patients. Methods The study end-point was OS, measured from the date of first metastatic presentation to death/last follow-up. A retrospe...
4 CitationsSource
#1David A. Palma (London Health Sciences Centre)H-Index: 57
#2Robert OlsonH-Index: 45
Last. Suresh Senan (VU: VU University Amsterdam)H-Index: 87
view all 24 authors...
PURPOSEThe oligometastatic paradigm hypothesizes that patients with a limited number of metastases may achieve long-term disease control, or even cure, if all sites of disease can be ablated. Howev...
76 CitationsSource
#1Bhumsuk Keam (Seoul National University Hospital)H-Index: 45
#2Eun Joo Kang (KU: Korea University)H-Index: 11
Last. Sung-Bae Kim (UOU: University of Ulsan)H-Index: 57
view all 13 authors...
6503Background: Adenoid cystic carcinoma (ACC) does not respond to cytotoxic chemotherapy. Several anti-angiogenic agents were evaluated in single arm phase II trials. However, the role of chemothe...
5 CitationsSource
#1Aman Sharma (IGMC: Indira Gandhi Medical College)H-Index: 30
#1Aman Sharma (IGMC: Indira Gandhi Medical College)H-Index: 2
Last. Joost J. Nuyttens (EUR: Erasmus University Rotterdam)H-Index: 29
view all 8 authors...
Abstract Purpose The study aimed to evaluate overall survival and local control, and to identify factors independently associated with overall survival (OS) and local control (LC). Materials and methods This retrospective study examined 118 patients with primary colorectal cancer, in whom 202 inoperable pulmonary oligometastases were treated with stereotactic body radiotherapy between 2005 and 2015. Primary endpoint was to evaluate OS and identify prognostic factors associated with OS. Secondary...
5 CitationsSource
#1Matthias Guckenberger (UZH: University of Zurich)H-Index: 69
#2Yolande Lievens (Ghent University Hospital)H-Index: 22
Last. Piet Ost (Ghent University Hospital)H-Index: 41
view all 20 authors...
Summary Oligometastatic disease has been proposed as an intermediate state between localised and systemically metastasised disease. In the absence of randomised phase 3 trials, early clinical studies show improved survival when radical local therapy is added to standard systemic therapy for oligometastatic disease. However, since no biomarker for the identification of patients with true oligometastatic disease is clinically available, the diagnosis of oligometastatic disease is based solely on i...
103 CitationsSource
#2Denise Bernhardt (University Hospital Heidelberg)H-Index: 14
Last. Matthias Guckenberger (UZH: University of Zurich)H-Index: 69
view all 26 authors...
Abstract Introduction This multicenter study aims to analyze outcome as well as early versus late patterns of recurrence following pulmonary stereotactic body radiotherapy (SBRT) for patients with oligometastatic non-small cell lung cancer (NSCLC). Materials and Methods This analysis included 301 oligometastatic NSCLC patients treated with SBRT for 336 lung metastases. While treatment of the primary tumor consisted of surgical resection, radiochemotherapy and/or systemic therapy, pulmonary oligo...
10 CitationsSource
#1Jungirl Seok (Seoul National University Hospital)H-Index: 4
#2Doh Young Lee (SNU: Seoul National University)H-Index: 14
Last. Soon Hyun Ahn (Seoul National University Hospital)H-Index: 15
view all 10 authors...
BACKGROUND: Distant metastasis of adenoid cystic carcinoma (ACC) is most commonly identified in the lung, but risk factors are still on debate. METHODS: Risk factors for lung metastasis were evaluated by using Cox proportional hazards model and Kaplan-Meier curves. RESULTS: Of 112 patients, 48% had distant metastasis; 94.4% of whom had lung metastasis. Univariable analysis revealed sublingual or minor salivary gland, tumor size ≥2.5 cm, and perineural invasion as risk factors (hazard ratio [HR]:...
4 CitationsSource
#1Pierluigi Bonomo (UniFI: University of Florence)H-Index: 20
#2Daniela Greto (UniFI: University of Florence)H-Index: 18
Last. Lorenzo Livi (UniFI: University of Florence)H-Index: 29
view all 12 authors...
Abstract Objectives Oligometastatic head and neck squamous cell carcinoma (HNSCC) is a rare entity with no evidence-based treatment recommendations available to support the use of local ablative therapies. The aim of our study was to report on the clinical benefit of stereotactic body radiotherapy (SBRT) for patients with lung-only oligometastases, defined by the presence of 1 to 5 pulmonary lesions. Material and Methods SBRT was applied in case of single lesions deemed amenable to local treatme...
9 CitationsSource
#1David A. Palma (London Health Sciences Centre)H-Index: 57
#2Robert OlsonH-Index: 45
Last. Suresh Senan (VU: VU University Amsterdam)H-Index: 87
view all 22 authors...
Summary Background The oligometastatic paradigm suggests that some patients with a limited number of metastases might be cured if all lesions are eradicated. Evidence from randomised controlled trials to support this paradigm is scarce. We aimed to assess the effect of stereotactic ablative radiotherapy (SABR) on survival, oncological outcomes, toxicity, and quality of life in patients with a controlled primary tumour and one to five oligometastatic lesions. Methods This randomised, open-label p...
485 CitationsSource
#1Davide FranceschiniH-Index: 19
#2Fiorenza De RoseH-Index: 15
Last. Marta Scorsetti (Humanitas University)H-Index: 41
view all 10 authors...
Purpose This study evaluated patients, treatment, or disease characteristics that could predict response to stereotactic body radiation therapy (SBRT) and survival in a database of patients with oligometastatic disease from different solid tumors. Methods and Materials Patients treated with SBRT for oligometastatic disease between 2014 and 2015 were included. Patients were defined as oligometastatic if they were affected by a maximum of 5 active lesions in 3 different sites. They had to be treat...
11 CitationsSource
Cited By1
Newest
#1Daijiro KobayashiH-Index: 7
#2Takanori Abe (Saitama Medical University)H-Index: 9
Last. Tatsuya Ohno (Gunma University)H-Index: 28
view all 10 authors...
Background Adenoid cystic carcinoma (ACC) is a rare malignant tumor involving mostly the head and neck region, and frequently the salivary glands. The development of lung metastasis after treatment of the primary tumor is a common occurrence in ACC. Although lung metastases show a slow rate of growth, approximately 10% of patients die from distant metastases. The radioresistance of ACC limits the efficacy of conventional radiotherapy for lung metastases, and the optimal dose remains to be determ...
Source